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Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke

Tae-Jin Song1,2, Young Dae Kim2, Joonsang Yoo3

  • 1Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.

Journal of Stroke
|August 5, 2016
PubMed

Insights

Aortic atheroma (AA) is common in acute stroke patients and linked to more severe cerebral small vessel diseases (SVDs). This includes cerebral microbleeds, white matter changes, and lacunar infarcts, highlighting a connection in systemic atherosclerosis.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Radiology

Background:

  • Cerebral small vessel diseases (SVDs) are associated with large artery atherosclerosis.
  • The link between aortic atheroma (AA) and cerebral SVDs is understudied.

Purpose of the Study:

  • To investigate the relationship between the presence and burden of aortic atheroma (AA) and cerebral small vessel diseases (SVDs).
  • To evaluate these associations in patients presenting with acute ischemic stroke.

Main Methods:

  • 737 acute ischemic stroke patients underwent transesophageal echocardiography (TEE) and brain MRI.
  • Aortic atheroma (AA) classified as complex (CAP) or simple (SAP).
  • SVDs assessed included cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), perivascular spaces (PVSs), and asymptomatic lacunar infarctions (ALIs).

Main Results:

  • Aortic atheroma (AA) detected in 48.8% of patients; 11.6% had CAP, 37.2% had SAP.
  • SVDs were present in 36.4% of patients.
  • AA presence correlated with CMBs, high-grade WMHs, high-grade PVSs, and ALIs.
  • Increased total SVD score was linked to higher odds of CAP and SAP.

Conclusions:

  • Patients with aortic atheroma (AA) frequently exhibit cerebral small vessel diseases (SVDs).
  • A greater burden of AA is associated with more advanced cerebral SVDs.
  • Findings suggest a positive association between systemic atherosclerosis and coexisting cerebral SVDs in acute ischemic stroke.
Abstract

Keywords:
Aortic atheromaCerebral small vessel diseasesWhite matter hyperintensity

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